Tommy John surgery repairs an injured elbow ligament. It’s most commonly done on college and pro athletes, especially baseball pitchers. But it’s sometimes done on younger people as well. The surgery is named after former Los Angeles Dodgers pitcher Tommy John. In 1974, he underwent the first surgery of this type. Tommy John surgery is also called UCL reconstruction. UCL is short for ulnar collateral ligament.

In the operation, the ligament in the elbow is replaced with a tendon. Previously, it used to be taken from a cadaver, but nowadays, the preferred donor tendon is from the patient’s own forearm, typically the one attached to the palmaris longus muscle. This tendon serves no real purpose and, in fact, about 15% of the population don’t have it – alternative sources include plantaris tendon in the ankle or a small part of the hamstring tendon, taken from the back rather than plant foot.

The surgeon will then drill a series of holes in the elbow. The tendon in question is inserted through the holes in a figure-eight pattern and locked in place. The aim is to provide it with a good supply of blood, to assist it in the healing process.

For the first week, the arm is kept in a hard brace, completely immobile; the subject can then start very gentle exercises, and by about two weeks after the surgery, it’s usually possible to restart everyday tasks like eating and combing his hair. However, any kind of pitching activity is still a long way off. The average wait is around four months, though it can be anywhere from three to six, depending on the patient’s recovery. It’s crucial not to rush the process. While the arm may feel great, there is a definite risk or re-injury should the new tendon/ligament be over-taxed, especially early on in recovery. As with any arm injury, the distance and velocity of the throwing is gradually increased, up until the pitcher is once again throwing off a mound. Here’s a typical time table.

However, that isn’t the end of the matter. It will often take another year for a pitcher to become completely comfortable with his new arm. Most major league pitchers return from ulnar collateral ligament reconstruction by the second season after surgery.

Provided by the Primus Sports Medicine Staff- OB

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After having an MRI, it has been confirmed that New York Knicks forward Carmelo Anthony has a small in his labrum of his right shoulder. After trying to play through this shoulder injury, Anthony did not play the last two games of the season.

The labrum is a soft fibrous tissue rim that surrounds the socket (formally known as the glenoid) of the shoulder. The labrum deepens the socket by up to 50% so that the head of the upper arm (humeral head) fits better into the socket. It also serves as an attachment sire for several ligaments.

Injuries to the labrum are commonly caused by acute trauma or repetitive shoulder motion, seen in throwing athletes and weightlifters. More traumatic injuries include, falling on an outstretched arm, a direct blow to the shoulder, a sudden pull, or a violet overhead reach.

Symptoms of a labrum tear include, like with most injuries, pain, more specifically with overhead activities. There may also be a catching, locking, popping, or grinding sensation in the shoulder. With this injury there may be a sense of instability and weakness in the shoulder, also a decrease in range of motion and strength.

Labrum injuries are typically diagnosed using an MRI or CT scan, as x-rays do not show this type of damage to the soft tissues. Early treatment includes anti-inflammatory medication and rest. Physical therapy may also be an early treatment for a labrum tear, focusing on strengthening the rotator cuff muscles. If these conservative treatments fail then surgery is usually recommended.

Carmelo Anthony will not be having surgery to repair his shoulder. Typical recovery after surgery is about 3 to 4 months with sport-specific exercises beginning about 2 months after surgery. Sources suspect that Anthony will make a full recovery for next season.

Provided by the Primus Sports Medicine Staff

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Paula Radcliffe who is an elite runner. She is an English long-distance runner, and is the current women world record hold in the marathon with time 2:15:25 hours. She is a three-time winner of the London Marathon (2002, 2003, 2005), three-time New York Marthon champion (2004, 2007, 2008) and won the 2002 Chicago Marathon. She had to withdrawal from 2012 Olympic due to a foot injury which ultimately required surgery.

Foot injuries are common among runner. One common injury is metarsalgia. The forefoot absorbs as much as 110 tons of cumulative force per mile during running, which makes your metatarsals, the five long bones that run from your arch to your toes, one impressive set of shock absorbers. When you push off the ground, your body weight is transferred to your metatarsals. If the weight distribution across the foot is uneven when it hits the road (because of foot’s mechanics, a tight Achilles tendon, or calluses), the metatarsals can become irritated and inflamed, resulting in metatarsalgia.

Patients feel a burning, stabbing, or aching pain at the head of the bone, just beneath the toes. It usually affects the second toe, and often the third or fourth. People complain that it feels like there’s a stone in their shoe. It’s worse when you stand, walk, or run, and better when you take a load off (especially if you’re at all overweight). It’s an equal-opportunity injury, affecting the flat-footed, the high-arched, and all soles in between. Symptoms can occur suddenly: after running barefoot on the beach, walking on a hard tile floor, or sprinting on pavement in worn-out shoes. But it usually builds over a few months.

Preventing metatarsalgia is often as simple as wearing the right shoes. If you have a flat or neutral foot, look for a shoe with a wide toebox and a dome-shaped metatarsal pad, which protects the metatarsals from pounding. Runners with high arches may benefit from a shock-absorbing insole that provides a platform for the foot and extra cushioning that deflects pressure from the bones. Visit a running specialty store for help outfitting your foot.

Improving your own support system doesn’t hurt, either. Strengthening the bottom of the foot prevents it from flattening excessively, which protects the metatarsals from impact. Strengthening the “plantar sling” muscles, which run on either side of the calf, helps control overpronation, one of the most common causes of metatarsalgia.

If you develop metatarsalgia, give your feet a break. Reduce your mileage, run on softer surfaces, or temporarily switch to a low-impact activity. Treat acute symptoms with ice during the first 24 hours and take anti-inflammatories as needed. See your doctor or a podiatrist if your symptoms don’t improve in 10 days. You may need a callus shaved, a different insert or metatarsal pad, or orthotics.

Exercises that will help prevent metatarsalgia

Plantar Sling Strengthener:

Anchor an exercise band tied in a loop to a desk leg. Place the arch of your right foot in the loop. Working against resistance, pull the band away from your center 10 times. Replace your right foot with your left, and pull toward your center. Turn around, face the opposite direction, and repeat: left foot pulls away, right foot pulls in. Progress to 30 reps per side.

Arch strengtheners: Pick up a marble with your toes, hold for a count of five, and release. Start at the big toe and repeat, working your way down to the little toe. Repeat three times.

Place a washcloth on a smooth surface and scrunch it up with your toes. Hold for a count of five, then release. Repeat 10 to 15 times.

Provided by Primus Sports Medicine Staff

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With baseball season underway, there is no doubt that we will likely see more shoulder injuries than any other sport. Throwing athletes, like baseball pitchers, play extremely high stresses on the shoulder, which can commonly lead to overuse type of injuries.

Phases of throwing

There are several shoulder injuries that some of your favorite baseball players have, or may, experience throughout their career.

Glenohumeral Internal Rotation Deficit (GIRD)

Extreme external rotation is required to throw at high speeds. This typically causes the ligaments at the front of the shoulder to stretch and loosen. A natural and common result is that the soft tissues in the back of the shoulder tighten, leading to loss of internal rotation.

This loss of internal rotation puts throwers at greater risk for labral and rotator cuff tears.

SLAP Tears (Superior Labrum Anterior to Posterior)

In a SLAP injury, the top part of the labrum is injured, the long head of the biceps tendon also attaches here. A SLAP tear occurs both in front (anterior) and in back (posterior) of this attachment point.

Typical symptoms are a catching or locking sensation, and pain deep within the shoulder.

Biceps Tendinitis

Repetitive throwing can inflame and irritate the long head of the biceps tendon, called biceps tendinitis. Pain in the front of the shoulder and weakness are common symptoms of biceps tendinitis.

Rotator Cuff Tendinitis and Tears

The rotator cuff is made up of four muscles that come together as tendons to form a covering around the head of the humerus. The rotator cuff is frequently irritated in throwers, resulting in tendinitis.

Early symptoms include pain that radiates from the front of the shoulder to the side of the arm.

As the damage worsens, the tendon can tear. When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus. Most tears in throwing athletes occur in the supraspinatus tendon.

Although these injuries are common in baseball, especially baseball pitchers, they can be seen in many other athletes who participates in sports that require repetitive overhand motions, such as volleyball, tennis, and some track and field events (e.g. javelin throwers). All of these injuries should be evaluated and treated by a physician. In most extreme cases, injuries such as SLAP and rotator cuff tears require surgery to fix. More conservative measures can be take with biceps tendonitis and GIRD.

Provided by Primus Sports Medicine Staff

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Carolina Panthers quarterback Cam Newton will underwent ankle surgery today , and he has an expected recovery time of four months. The injury, to his left ankle, has persisted since Carolina’s playoff loss to San Francisco on Jan. 12, 2014. Team physician and renowned ankle surgeon Dr. Robert Anderson performed the procedure at Carolinas Medical Center.The timeline puts Newton out until the start of training camp in late July, meaning he will miss organized team activities this spring. The ankle has given Newton, who had his most successful season as a professional, pain this offseason. Newton said he “nicked” his ankle in the win against New Orleans in Week sixteen of last season.

Assuming Newton’s surgery goes as expected, the could be throwing again by the middle of June. Panthers quarterback Cam Newton will need as much time as possible to work with his new receivers. Carolina lost its top four wide receivers from last season in free agency. Having Newton available sooner would be important as he will be confronted with the challenge of developing timing with a new receiver group as Steve Smith (Baltimore Ravens), Brandon LaFell ( New England Patriots) and Ted Ginn Jr. (Arizona Cardinals) have all signed elsewhere as free agents.

The ankle is stabilized by 3 ligaments on the outside and one large ligament on the inside of the ankle joint. The ligaments on the outside of the ankle are most commonly injured. These ligaments can be stretched or torn with a roll, twist, or misstep of the foot. The symptoms include swelling, pain, and decreased range of motion. After a sprained ankle, the athlete is at increased risk for future sprains. The treatment is rest, ice, compression, and physical therapy to strengthen the muscles of the foot and ankle, focusing on balance. The recovery time is variable depending on the severity of the sprain. Mild sprains recover within a few days, moderate sprains normally recover in 1-3 weeks (but may require protective bracing for 5-8 weeks). Severe sprains may take 6-12 months to fully recover, although return to sports is generally much sooner. Only the most severe and unstable ankle sprains require surgery. Ligament instability reconstructions for the ankle require three to four months to fully heal, with full strength and sport activity occurring closer to five to six months. This comes with extensive physical therapy and training for balance, agility, and conditioning.